MORARJI DESAI NATIONAL INSTITUTE OF YOGA

(MDNIY)
आयुषमं त्रालय, भारतसरकार
(Ministry of AYUSH, Govt. of India)
68, अशोक रोड़, नई दिल्ली-110001
68, Ashok Road, New Delhi-110001

PROFORMA

1. Name
2. Post applied for
3. a) Present post held (whether
regular, ad-hoc or on deputation
basis).
b) If presently on deputation, please
indicate designation of the post held
in the parent office/cadre and scale
of pay of that post along with the
present basic pay in that grade.
4. Present Pay Band and Grade Pay
(also mention Basic Pay)
5. Date of getting the present scale on
regular basis.
6. Date of Birth
7. Date of entry into service (including
service & batch)
8. Date of retirement
9. Office Address
10. Phone & FAX Number with STD
code
11. E-mail address
12. Education Qualifications
13. Position held since entry into service (in chronological order)

Designation & Scale of Pay From To Whether post held

Place of (pre-revised) on regular or ad-
posting hoc basis

14. Applicant must indicate how the

eligibility criteria like number of
years of service rendered in the
relevant pay scale, educational
qualification, experience in the
relevant filed, age on closing date of
applications and period are fulfilled.
15. Name and address, telephone
number of concerned officer in the
office of the Cadre Controlling
Authority.
Note: Column 14 & 15 must be filled.

Date:
Signature of the candidate

Particulars of the applicant verified

Signature of Cadre Controlling Authority

Along with stamp
 ANNEXURE-I

(Cadre clearance and Vigilance clearance) FOR THE USE OF CADRE CONTROLLING
AUTHORITY/DEPARTMENT ONLY

1. Whether the officer meets eligibility requirement

as on the closing date of application

2.(i) Whether the officer has been placed on the Agreed

List or List of Officers of Doubtful Integrity (If Yes
the details to be given)
2.(ii) Whether any allegation of misconduct involving
vigilance angle was examined against the officer
during the last 10 years and if so with what result
2.(iii) Whether any punishment was awarded to the
officer during last 10 years and if so that date of
imposition and details of the penalty
2.(iv) Is any disciplinary/criminal proceedings or charge
sheet pending against the officer as on date [If so
details to be furnished including reference no., if
any of the Commission]
2.(v) If any action contemplated against the officer as
on date [If so details to be furnished]

2.(vi) Date of filling of latest IPR

3 Whether cadre clearance for the officer by the

Competent Authority has been granted.

4 Whether integrity of the officer is certified.

It is certified that the information/entries furnished by the officer has been verified
from the service records of the Officer.

Date

Signature…………………………….

Name …………………………………

Designation (with stamp)………………………………